TR
EN
Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report
Öz
Stent underexpansion due to severe calcification remains a significant challenge in percutaneous coronary intervention, particularly in patients with overlapping stents. We aimed to demonstrate the efficacy of intravascular lithotripsy in managing refractory stent underexpansion when conventional techniques fail.
A 71-year-old male with multiple cardiovascular risk factors and prior coronary artery bypass grafting presented with recurrent angina due to severe underexpansion of overlapping stents in the mid-right coronary artery. Despite aggressive preparation with non-compliant and cutting balloons across multiple sessions, adequate stent expansion could not be achieved. Intravascular ultrasound revealed circumferential calcification extending 270 degrees around the vessel with double-layered underexpanded stents. Intravascular lithotripsy was employed followed by high-pressure balloon dilatation to achieve optimal stent expansion. The patient tolerated the procedure without complications and reported complete resolution of anginal symptoms at post-discharge follow-up.
This case demonstrates that intravascular lithotripsy is a highly effective and safe treatment option for severe stent underexpansion in the setting of heavy circumferential calcification when conventional balloon-based techniques fail.
Anahtar Kelimeler
Etik Beyan
Kurumsal yönergelere göre, tek bir hastadan elde edilen klinik bulguları sunduğu için bu olgu sunumu için etik kurul onayı gerekmemektedir.
Kaynakça
- Fujii K, Carlier SG, Mintz GS, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol. 2005;45(7):995-998.
- Choi SY, Witzenbichler B, Maehara A, et al. Intravascular ultrasound findings of early stent thrombosis after primary percutaneous intervention in acute myocardial infarction: a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) substudy. Circ Cardiovasc Interv. 2011;4(3):239-247.
- Bourantas CV, Zhang YJ, Garg S, et al. Prognostic implications of coronary calcification in patients with obstructive coronary artery disease treated by percutaneous coronary intervention: a patient-level pooled analysis of 7 contemporary stent trials. Heart. 2014;100(15):1158-1164.
- Nakamura D, Lee JM, Doh JH, et al. Reassessment of optimal stent expansion after drug-eluting stent implantation. Circ Cardiovasc Interv. 2020;13(6):e008871.
- Généreux P, Madhavan MV, Mintz GS, et al. Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. Pooled analysis from the HORIZONS-AMI and ACUITY trials. J Am Coll Cardiol. 2014;63(18):1845-1854.
- Lee MS, Yang T, Dhoot J, Iqbal Z, Liao H. Meta-analysis of studies comparing coronary artery atherectomy to balloon angioplasty before stent implantation for calcified coronary lesions. Am J Cardiol. 2018;122(6):952-961.
- Ali ZA, Nef H, Escaned J, et al. Safety and effectiveness of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: the Disrupt CAD II Study. Circ Cardiovasc Interv. 2019;12(10):e008434.
- Hill JM, Kereiakes DJ, Shlofmitz RA, et al. Intravascular lithotripsy for preparation of calcified coronary lesions. JACC Cardiovasc Interv. 2020;13(15):1837-1844.
Ayrıntılar
Birincil Dil
İngilizce
Konular
Klinik Tıp Bilimleri (Diğer)
Bölüm
Olgu Sunumu
Yayımlanma Tarihi
10 Haziran 2026
Gönderilme Tarihi
18 Ocak 2026
Kabul Tarihi
3 Mart 2026
Yayımlandığı Sayı
Yıl 2026 Cilt: 65 Sayı: 2
APA
Polat, F., & Terzı, S. (2026). Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. Ege Tıp Dergisi, 65(2), 340-344. https://doi.org/10.19161/etd.1866180
AMA
1.Polat F, Terzı S. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. ETD. 2026;65(2):340-344. doi:10.19161/etd.1866180
Chicago
Polat, Fuat, ve Sait Terzı. 2026. “Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report”. Ege Tıp Dergisi 65 (2): 340-44. https://doi.org/10.19161/etd.1866180.
EndNote
Polat F, Terzı S (01 Haziran 2026) Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. Ege Tıp Dergisi 65 2 340–344.
IEEE
[1]F. Polat ve S. Terzı, “Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report”, ETD, c. 65, sy 2, ss. 340–344, Haz. 2026, doi: 10.19161/etd.1866180.
ISNAD
Polat, Fuat - Terzı, Sait. “Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report”. Ege Tıp Dergisi 65/2 (01 Haziran 2026): 340-344. https://doi.org/10.19161/etd.1866180.
JAMA
1.Polat F, Terzı S. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. ETD. 2026;65:340–344.
MLA
Polat, Fuat, ve Sait Terzı. “Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report”. Ege Tıp Dergisi, c. 65, sy 2, Haziran 2026, ss. 340-4, doi:10.19161/etd.1866180.
Vancouver
1.Fuat Polat, Sait Terzı. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. ETD. 01 Haziran 2026;65(2):340-4. doi:10.19161/etd.1866180